Provider Demographics
NPI:1003403619
Name:HOFFMAN, THIA JANAI (CERTIFIED OPHTH TECH)
Entity Type:Individual
Prefix:
First Name:THIA
Middle Name:JANAI
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:CERTIFIED OPHTH TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7936 DEPEW ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2528
Mailing Address - Country:US
Mailing Address - Phone:303-521-7198
Mailing Address - Fax:
Practice Address - Street 1:7936 DEPEW ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2528
Practice Address - Country:US
Practice Address - Phone:303-521-7198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1234156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1234OtherN/A